As a primitive driving force for biological reproduction, sexual behavior (and its associated mechanisms) is extremely complex, and orgasm plays an essential role. The limbic system plays a very important role in regulating human sexual behavior. However, it is not clear which components of the limbic system are related to orgasm sensation. We studied a rare case of spontaneous orgasmic aura in a male patient with temporal lobe epilepsy. Stereoelectroencephalography (SEEG) revealed that the right amygdala was the origin of orgasmic aura. Surgical removal of the medial temporal lobe, including the right amygdala, completely eliminated the patient\'s seizures. This study demonstrates the critical role of the amygdala in human male orgasm.

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients\' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men\'s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: \"low libido\", \"erectile dysfunction\", \"ejaculatory dysfunction\", \"premature ejaculation\", \"retrograde ejaculation\", \"delayed ejaculation\", \"anejaculation\", and \"orgasmic dysfunction\" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient\'s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

BACKGROUND: Acupuncture has potential in the treatment of female sexual dysfunction (FSD), but its effectiveness needs to be verified.
OBJECTIVE: A meta-analysis to provide a summary of studies that had investigated the efficacy of acupuncture as a treatment for FSD.
METHODS: A systematic screening was conducted on electronic databases such as Pubmed, Embase, Cochrane Library, CNKI, and CBM to select studies that met the criteria before April 2023. We only included those studies assessing women\'s sexual functioning by the Female Sexual Function Index (FSFI).
RESULTS: By calculating the relative risk (RR) using the standardized mean difference (SMD) and 95% confidence interval (CI), these data were combined to generate a summary of the findings. The pooled results were calculated using a random-effects model.
RESULTS: A total of 4 studies involving 178 participants were included, and the comprehensive results indicated a significant difference in FSFI scores between the acupuncture group and the control group. In the desire and arousal scale, there was a statistically significant difference between the acupuncture group and the control group. But in the scale of lubrication, orgasm, satisfaction, and pain, there was no statistically significant difference between the two groups.
CONCLUSIONS: A comparison of overall FSFI scores, sexual desire, and sexual arousal revealed that acupuncture treatment can improve female sexual dysfunction to some extent. However, in terms of vaginal lubrication, orgasm, sexual satisfaction, and sexual pain, acupuncture treatment did not significantly improve female sexual dysfunction. In the future, it is necessary to include more RCT trials and expand the number of patients analyzed to make the conclusions more reliable.

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OBJECTIVE: Despite high-interest rates in sex in people with hip osteoarthritis (OA), clinicians tend not to address sexual issues, especially in older adults. The objective of this study is to evaluate sexual activity and factors associated with sexual activity satisfaction in people with symptomatic hip OA.
METHODS: A cross-sectional study was conducted among 252 participants with symptomatic hip OA in Australia. Quality of sex life was assessed using the online composite of sexual activities and positions questionnaires. A Poisson model with robust variance was used to calculate the prevalence ratio (PR). Factors that showed a univariate association with sexual satisfaction were then included in a multivariable model. PR with corresponding 95% confidence intervals (CI) are reported.
RESULTS: Among the 282 participants registered on the study website, 252 met the inclusion criteria, and 60.3% (152/252) completed the sexual activity questionnaires. Hip OA interfered with sexual activity in 70.0% of the participants. High confidence in completing sexual activity (PR: 0.53, 95% CI: 0.36 to 0.77) was associated with an increased prevalence ratio of sexual satisfaction. High anxiety, depression or stress during sexual activity (PR: 1.33, 95% CI: 1.10 to 1.60) was associated with an increased prevalence ratio of sexual dissatisfaction after adjusting for hip pain level and perceived partner\'s orgasm.
CONCLUSIONS: Although a large proportion of people with hip OA remain sexually active, a substantial proportion of persons are dissatisfied with their sexual activity. Hip OA interfered with sexual activity in most participants. Psychological factors were found to be associated with sexual activity satisfaction.

Sexual satisfaction is one of the issues faced by breast cancer survivors (BCSs).
This study aims to explore the mediation of stigma in the relationship between perceived social support (PSS) and sexual satisfaction among breast cancer survivors.
A cross-sectional study was conducted among 918 BCSs in Shanghai Cancer Rehabilitation Club. Data were collected using an online questionnaire including questions on sociodemographic characteristics, health status, PSS, stigma and sexual satisfaction of participants. The bootstrap method was used to test the significance of the simple mediation model.
The simple mediation of stigma was found significant in the relationship between PSS and sexual satisfaction.
Stigma plays an intermediary role in the relationship between 2 dimensions of PSS (family and friends) and sexual satisfaction, but not in the relationship between the dimension of other significant people of PSS and sexual satisfaction.
It is important to reduce stigma when improving the sexual satisfaction of BCSs from the perspective of PSS.
The mediating role of stigma in the relationship between PSS and sexual satisfaction among BCSs has been shown for the first time. Study limitations include limitations in the representativeness of population by the study sample and the cross-sectional study design.
Stigma mediates the relationship between PSS and sexual satisfaction, which needs to be eliminated in intervention practice.

Sexual satisfaction is one of the issues faced by breast cancer survivors (BCSs).
This study aims to explore the mediation of stigma in the relationship between perceived social support (PSS) and sexual satisfaction among breast cancer survivors.
A cross-sectional study was conducted among 918 BCSs in Shanghai Cancer Rehabilitation Club. Data were collected using an online questionnaire including questions on sociodemographic characteristics, health status, PSS, stigma and sexual satisfaction of participants. The bootstrap method was used to test the significance of the simple mediation model.
The simple mediation of stigma was found significant in the relationship between PSS and sexual satisfaction.
Stigma plays an intermediary role in the relationship between 2 dimensions of PSS (family and friends) and sexual satisfaction, but not in the relationship between the dimension of other significant people of PSS and sexual satisfaction.
It is important to reduce stigma when improving the sexual satisfaction of BCSs from the perspective of PSS.
The mediating role of stigma in the relationship between PSS and sexual satisfaction among BCSs has been shown for the first time. Study limitations include limitations in the representativeness of population by the study sample and the cross-sectional study design.
Stigma mediates the relationship between PSS and sexual satisfaction, which needs to be eliminated in intervention practice. Yuxin Zhang, Jie Zhao, Nan Jiang, et al. Effects of Stigma on the Relationship Between Perceived Social Support and Sexual Satisfaction Among Breast Cancer Survivors. J Sex Med 2022;19:1002-1011.

This network meta-analysis aimed at assessing the influence of tramadol on the intravaginal ejaculatory latency time (IELT) and sexual satisfaction score (SSS) in treating patients with premature ejaculation (PE). The PubMed, Embase, Cochrane Library databases (until July 2021), and original references of the included articles was systematically retrieved. The PRISMA checklist was followed. Finally, 14 articles including 1971 patients were included in this analysis. The results indicated that patients who were treated with tramadol (50 mg, 62 mg, 89 mg, and 100 mg) were superior to those treated with placebo in terms of IELT (p = .003, p < .00001, p < .00001, and p < .00001, respectively), but 25 mg tramadol did not show a significant advantage (p = .06). Patients who were treated with tramadol (50 mg and 100 mg) had a better efficacy than who were treated with 25 mg tramadol in the IELT (p < .00001 and p < .00001), but the effect of 50 mg tramadol and 100 mg tramadol were not significantly different (p = .17). The tramadol group had the better effect than the placebo group in the SSS (p < .0001). And 50 mg tramadol showed a significant improvement compared with 20 mg paroxetine, as assessed by the IELT (p = .03) and SSS (p = .03). Safety assessments including adverse events suggested that tramadol was well tolerated. Tramadol showed a better improvement of IELT and SSS than placebo or paroxetine, and 50 mg tramadol may be a more reasonable therapeutic dose for patients with PE.

Post-traumatic olfactory dysfunction (PTOD) is associated with a significant decrease in quality of life. The present study aimed to explore whether PTOD is associated with depression and changes in sexuality. There were two groups in this case-control study. The patient group consisted of patients with PTOD (n = 55), and the control group comprised healthy individuals without the olfactory disorder (n = 115). Olfactory function, depression, partnership, and sexual satisfaction were assessed using the Iranian version of the Sniffin\' Sticks test (Ir-SST), Beck Depression Inventory (BDI), Enrich Couple Scale (ECS) and Sexual Satisfaction Scale for Women (SSSW). The BDI scores were higher in the patient group than in the control group (p < 0.001). The SSSW score was lower in the patient group than in controls (p < 0.01), although the ECS score was not significantly different between patients and controls. Also, there was no significant difference in the severity of trauma between marital satisfaction and sexual satisfaction. However, the analysis showed a statistically significant difference in depression scores in connection with the head trauma severity. In the PTOD group, depression was increased and sexual satisfaction declined. Understanding the association of olfactory dysfunction with depression and sexuality allows patients and doctors to deal with less notable consequences of this disorder.

UNASSIGNED: This study was to evaluate the impact of the symptoms of overactive bladder (OAB) syndrome on female sexual function. Seventy nine patients with OAB (OAB group) and 79 healthy women (control group) underwent physical examination at our center, and had their sexual function evaluated using the female sexual function index (FSFI). In accordance with the presence or absence of urge incontinence, the OAB group was further divided into the wet and dry groups. The sexual function was evaluated again after 3 months of pharmacotherapy. We investigate the difference of sexual function between OAB and control group. The effect of OAB severity and OAB pharmacotherapy on sexual function was also explored. There were no significant differences between OAB group and control group, including age, body mass index (BMI), education, occupation, fertility, parity, childbirth, and menopause. Compared with the control group, the OAB group had significantly lower FSFI scores. The respective mean ± standard error FSFI scores in the control group and the OAB group were 2.98 ± 1.07 and 2.27 ± 0.96 for desire, 3.48 ± 1.16 and 2.32 ± 1.44 for arousal, 4.60 ± 1.13 and 3.10 ± 1.95 for lubrication, 3.37 ± 0.87 and 2.63 ± 1.04 for orgasm, 3.58 ± 1.02 and 2.41 ± 1.35 for sexual satisfaction, 3.58 ± 1.02 and 2.41 ± 1.35 for sexual pain, and 22.24 ± 5.29 and 15.59 ± 7.47 for the total score (P < .05 for all comparisons). The scores for desire, lubrication, orgasm, sexual satisfaction, pain, and total FSFI between the OAB-dry and OAB-wet subgroup were similar while score of arousal in OAB-wet subgroup was significantly increased compared with that of OAB-dry. OABSS score was commonly used in the assessment of OAB severity. The difference of the FSFI scores among mild OAB group, moderate OAB group, and severe OAB group was statistically significant (P < .05). Female FSFI sexual function scores were significantly improved after OAB pharmacotherapy (P < .05). Women with OAB syndrome have poorer sexual function than healthy women. Patients with more serious OAB experience more disturbing sexual dysfunction. Female sexual function scores were significantly improved after OAB pharmacotherapy.